Advanced

AJNR - American Journal of Neuroradiology

This Article Figures Only Full Text Full Text (PDF) Alert me when this article is cited Alert me if a correction is posted Citation Map Services Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Download to citation manager Citing Articles Citing Articles via HighWire Citing Articles via CrossRef Citing Articles via Google Scholar Google Scholar Articles by Eida, S. Articles by Nakamura, T. Search for Related Content PubMed PubMed Citation Articles by Eida, S. Articles by Nakamura, T.

American Journal of Neuroradiology 24:312-318, March 2003
© 2003 American Society of Neuroradiology

HEAD AND NECK

Combination of Helical CT and Doppler Sonography in the Follow-up of Patients with Clinical N0 Stage Neck Disease and Oral Cancer

Sato Eida^a, Misa Sumi^a, Koichi Yonetsu^a, Yasuo Kimura^a and Takashi Nakamura^a

^a From the Department of Radiology and Cancer Biology, Nagasaki University School of Dentistry, Nagasaki, Japan

Address reprint requests to Takashi Nakamura, Department of Radiology and Cancer Biology, Nagasaki University School of Dentistry, 1-7-1 Sakamoto, Nagasaki 852-8588, Japan

BACKGROUND AND PURPOSE: Correctly diagnosing metastatic nodes is important for the follow-up of patients with clinical N0 stage neck disease and oral cancer. A combination of helical CT and Doppler sonography may facilitate the accurate detection of lymph node metastasis in patients with clinical N0 stage neck disease.

METHODS: A combination of contrast-enhanced helical CT and Doppler sonography was performed to monitor the necks of 58 patients with initial clinical N0 stage neck disease. Of these patients, 17 underwent surgery; nodal metastasis in the neck was histopathologically confirmed. A node was diagnosed as metastatic if it fulfilled the CT criteria for metastatic nodes (short-axis diameter equal to or greater than the cutoff points for each level of the neck or central nodal necrosis) and if, additionally, it did not exhibit sonographic features for nonmetastatic nodes (normal hilar echogenicity and hilar flows). The presence of metastasis was confirmed histopathologically.

RESULTS: During the follow-up periods, metastatic nodes were histologically confirmed in 17 (29%) patients. Of 30 metastatic nodes from the 17 patients with metastatic nodes, 22 (73%) appeared within the first year and 28 (93%) within the first 2 years; 20 developed from nonmetastatic nodes, and 10 were newly detectable. The combined criteria were effective in revealing 26 (87%) nodes, yielding 87% sensitivity, 100% specificity, and 100% positive and 99% negative predictive values. The independent use of one of these techniques alone resulted in low (67%) or moderate (87%) positive predictive values for sonography and CT, respectively. Seven hundred forty-one (97%) of 761 nodes that were nonmetastatic at initial examination remained nonmetastatic (737 nodes) or had disappeared (four nodes). As a result, a combination of CT and sonography was effective in revealing all 17 cases of metastatic nodes.

CONCLUSION: A combination of contrast-enhanced helical CT and Doppler sonography is useful for the follow-up study of clinical N0 stage neck disease.

This article has been cited by other articles:

				Y. Kawai, M. Sumi, and T. Nakamura Turbo Short {tau} Inversion Recovery Imaging for Metastatic Node Screening in Patients with Head and Neck Cancer AJNR Am. J. Neuroradiol., June 1, 2006; 27(6): 1283 - 1287. [Abstract] [Full Text] [PDF]

				M. Sumi, M. Van Cauteren, and T. Nakamura MR Microimaging of Benign and Malignant Nodes in the Neck. Am. J. Roentgenol., March 1, 2006; 186(3): 749 - 757. [Abstract] [Full Text] [PDF]

				B. F. Branstetter IV, T. M. Blodgett, L. A. Zimmer, C. H. Snyderman, J. T. Johnson, S. Raman, and C. C. Meltzer Head and Neck Malignancy: Is PET/CT More Accurate than PET or CT Alone? Radiology, May 1, 2005; 235(2): 580 - 586. [Abstract] [Full Text] [PDF]